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The reverse flow medial knee osteoperiosteal flap for skeletal reconstruction of the leg

Bases anatomiques du lambeau ostéopériosté à pédicule distal du tiers inférieur du fémur dans les reconstructions du squelette jambier

Description and anatomical basis

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Summary

A new, pedicled, reverse flow osteoperiosteal flap based on 2 branches of the descending genicular a. is presented. Both a Periosteal and osteoperiosteal flap Can be raised at the distal end of the femur and, in favourable cases (64% of the dissections), transported as far as the middle third of the leg. In all other cases the Proximal third of the tibia can be reached. Composite musculo-osteoperiosteal flaps can also be raised, including the articularis genus m. Clinical applications may include the treatment of nonunions, reconstruction of segmental tibial defects and bone revascularisation in aseptic necrosis about the knee Joint.

Résumé

Cinquante dissections ont précisé les bases anatomiques d'un lambeau périosté ou ostéopériosté, dont la perfusion se fait en flux rétrograde le plus souvent sur Taxe saphène interne, puis en flux orthograde sur la branche ostéoarticulaire de l'a. descendante du genou. Un lambeau composite musculo-ostéopériosté peut également être levé, en incluant le m. articulaire du genou. Dans les cas favorables (64 % des dissections) ce lambeau peut être transporté jusqu'au tiers moyen de la jambe. Le tiers supérieur peut toujours être atteint. Les applications cliniques sont à envisager dans le traitement des pseudarthroses tibiales, des pertes de substance tibiales, ou des nécroses aseptiques au niveau du genou.

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Abbreviations

DGA :

descending genicular a.

DPB :

diaphyseal periosteal branch

LIGA :

lateral inferior genicular a.

LSGA :

lateral superior genicular a.

MIGA :

medial inferior genicular a.

MSGA :

medial superior genicular a.

MB :

muscular branch

OAB :

osteo-articular branch

PA :

popliteal a.

SA :

Saphenous br.

SFA :

femoral a.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Berne, Switzerland

    R. Hertel

  2. Service de Chirurgie Orthopédique et Réparatrice, Hôpital Avicenne, 125, route de Stalingrad, F-93000, Bobigny, France

    A. C. Masquelet

Authors
  1. R. Hertel
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  2. A. C. Masquelet
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Hertel, R., Masquelet, A.C. The reverse flow medial knee osteoperiosteal flap for skeletal reconstruction of the leg. Surg Radiol Anat 11, 257–262 (1989). https://doi.org/10.1007/BF02098691

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  • DOI: https://doi.org/10.1007/BF02098691

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